Affordable Care Act frequently asked questions

Derisively dubbed “Obamacare” by detractors, the nickname for the Affordable Care Act was later embraced by the president himself.

The confusion doesn't end there. According to a poll by the nonprofit, nonpartisan Kaiser Family Foundation, four out of 10 Americans remain perplexed about how the law will affect them — and their wallets.

But the re-election of President Barack Obama means the law, like it or not, is going full-steam ahead, and millions of Americans stand to be affected.

Now it's time for the bugs to be shaken out.

States were supposed to let the federal government know by Friday — just days after the election — whether they would set up their own health care exchanges, online “shopping centers” where uninsured, middle-class people could look for the best insurance deals. Late Thursday, that deadline was extended to Dec. 14 at the request of Republican governors.

Florida's incoming House Speaker Will Weatherford, R-Wesley Chapel, and Senate President Don Gaetz, R-Niceville, sent a letter to the U.S. Department of Health and Human Services Thursday stating that Florida could not commit to the exchanges until after the Legislature convenes in March.

They also said they needed answers to a number of questions about the state's involvement, suggesting a willingness to work with the federal government.

Gov. Rick Scott, who has recently softened his opposition to the Affordable Care Act, told federal health officials in a letter Friday that he's worried the actual costs could end up exceeding early estimates and requested a meeting in hopes of working together to set up a state health exchange.

So, peeling away the election rhetoric, the feel-good platitudes and nasty invectives, here are some basic facts about what the Affordable Care Act means for you and your family.

Q: Is all of this happening sometime in the future?

A: No. While most changes begin Jan. 1, 2014, a number already have occurred:

• Children up to age 26 can be covered by parents' insurance plans.

• Preventive services such as breast cancer screenings and some blood tests likely are available to you now at no cost.

• Children with pre-existing conditions can't be denied coverage. (This will extend to adults in 2014.)

• If you get sick, insurance companies can no longer boot you off their plans.

• Insurance companies have to provide rebates if customers spend less than 80 to 85 percent of their premiums on medical care.

Q: I like my doctor. Can I keep him or her?

A: Yes. The law doesn't dictate which physicians you can use. As is already the case, your own insurance plan can.

Q: Am I going to be forced to buy insurance? I can't afford it.

A: Not immediately, but many people will in 2014 or face a fine, starting at $95 per year or up to 1 percent of income, whichever is more. For families, that would be $2,085 or 2.5 percent of income, whichever is more.

However, the act contemplates the expansion of Medicaid to cover millions more people. Federal subsidies also will help people pay for insurance.

Q: What if I refuse to pay the fine?

A: You won't be prosecuted, and there will be no liens or levies on your property. The government could come after any tax refund.

Q: Will I qualify for Medicaid?

A: Beginning in 2014, an individual who makes roughly $15,000 or less per year, or a family of four making about $30,500 or less, are to be eligible for free or low-cost care through the expansion of Medicaid. Scott has questioned whether Florida can afford the expansion, though the law calls for the federal government to pick up the cost for the first three years. Under the U.S. Supreme Court ruling upholding the law, states can opt out of the expansion. It is not yet clear what will happen in Florida.

Q: I make too much. What about those federal subsidies?

A: Exchanges, the state-based insurance marketplaces being quibbled about now, will let employers and consumers shop for the best deals and learn about subsidies. They kick in for individuals making about $15,000 to $44,680 annually and for families of four with incomes of about $30,656 to $92,200. Those numbers are based on current guidelines and might change slightly by 2014.

Q: What if I like the insurance I get through my employer?

A: You can keep it.

Q: I own a small business and can't afford insurance for my employees. Do I have to provide it?

A: Employers with up to 50 workers won't be penalized for failing to provide insurance. Beginning in 2014, it gets complicated if you have more than 50 employees. If at least one full-time worker gets subsidized coverage through the health insurance exchange, you'll have to pay $2,000 per full-time worker. But the first 30 workers are exempt.

However, you might get a tax credit to help cover the costs. Check with a financial adviser for details.

Q: I have a pre-existing condition and am uninsurable. Am I still out of luck?

A: As of Jan. 1, 2014, no one can deny you coverage because of pre-existing conditions.

Q: What about older people?

A: Not too much is expected to change for Americans older than 65 on Medicare. Its so-called “doughnut hole” will narrow and finally close by 2020, which means older adults will no longer have to cover as much of their prescription costs.

Q: I make a good wage and have insurance. Am I going to end up paying more for my health care because of this?

A: Nobody knows for sure, but many think yes. Starting in 2013, individuals earning more than $200,000 a year and married couples making more than $250,000 will have an increased payroll tax of 2.35 percent, up from 1.45 percent now.

The law also will tax and collect fees from a number of health-care industries, which may pass along the costs to consumers.

Information from the Associated Press, The New York Times and the Kaiser Family Foundation was used in this report.

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